Muhammad Amirul Bin Muhamad, a writer from The Smart Local, goes through our fall assessment and learns how to look out for signs in the elderly.
Growing up, one thing that I’ve realised about my parents is that they’re very sneaky people, especially when it comes to their health. They’ll make a fuss of me falling sick – “See doctor already or not? Take medicine. Ask for MC. I make porridge for you.” But when the flu bug hits them, suddenly sleep and panadol is all the remedy you need.
Granted, all these come from a good place. They don’t want to burden us with their woes, so they try to conceal as much as they can. But as we grow older, this can be dangerous, especially when they face greater risks of falling.
Mount Alvernia Hospital recently introduced a new fall screening service meant to help you assess their risk of falling and improve your parents’ overall stability and strength. Together with my new friend Gladys, I went through the screening recently, and learnt that there are many fall-related signs that we all tend to overlook when it comes to our parents. Here are the warning signs to look out for.
1. THEY MASSAGE THEIR LEGS TOO FREQUENTLY, SOMETIMES UNKNOWINGLY.
Your parents’ tendency to massage their calves and thighs after sitting down may not be “just an old people thing”. They may be experiencing strain from only having done minimal movement. Also listen out for when they casually complain about how tiring it is to travel over short distances.
All of these habits are more telling than you think. If left unaddressed, straining when sitting down and getting up may deteriorate into prolonged pain even when moving around. Self-massaging provides temporary relief but doesn’t address underlying issues that are causing such weakness in the legs.
Fall assessment #1: Knee Strength Test
This simple test measures your parents’ leg strength. Using a simple mechanism that can be attached to any chair, all that’s required of your parents is a steady lift of the leg. I’m no gym buff but this test felt familiar – think of it as a reverse leg curl that even your grandmother can do.
Their leg strength will be measured based on the distance they’re able to extend their leg, and even my leg could feel some resistance as I went through the motion. Prior to this, the physiotherapist will check with them to determine any pre-existing conditions or injuries.
2. THEY AVOID TAKING THE STAIRCASE EVEN IF IT’S MORE CONVENIENT.
Between taking the stairs and the escalator, the choice is always clear, even for us young’uns. But keep an eye out for your mother’s quiet insistence on not taking the stairs, opting instead to walk through winding disabled-friendly ramps when it comes to things like crossing overhead bridges.
This could mean a few things:
1. That they’re not confident of landing their steps,
2. or that they have difficulty perceiving the distance and depth of the steps before them.
Don’t let this go unnoticed – the more they avoid stairs, the weaker their sense of perception will be.
Fall assessment #2: Joint Position Sense Test
This test determines how in-sync the joints in their legs are. They’ll be required to lift their legs forward at low, mid and high positions before bringing them close together. From the get-go, I assumed that it would be a fairly easy task – until I was told to do it with my eyes closed.
Gladys fared much better than me here, proving that she has a greater awareness of her joints than I do. Here’s the thing about these tests – they don’t just show you which areas need work, they’ll also reinforce where you’re strong and how they can be maintained.
3. THEY SQUINT WHEN THEY’RE OUT BECAUSE THEY CAN’T SEE THE PATH AHEAD OF THEM CLEARLY.
I’m not talking about your father’s “resting grumpy face” here. When your parents are squinting, it isn’t always out of judgement or disapproval – it might mean that they legit can’t see clearly. This applies especially when it’s too bright out or when it gets really dark, making it hard for them to distinguish subtle things like lines on a traffic sign or directions on a board.
Squinting might seem like an innocuous quick fix but it’s potentially dangerous as well. It requires too much concentrated focus on their part and prevents them from being fully aware of the rest of their surroundings.
Fall assessment #3: Vision Test
This test evaluates their edge contrast sensitivity, aka how well they differentiate between variations of light vs dark. It’s actually a simple task of matching corresponding circles – or so I thought.
When I got to the less distinct circles, I experienced the same kind of anxiety that I typically feel during screening tests when getting a new pair of spectacles – “Am I seeing this right or is it a trick image and there’s actually nothing there?” At this point, Gladys took comfort in my inability to discern the last few images as well.
4. THEY HAVE A DELAYED RESPONSE TO CHANGING TRAFFIC LIGHTS.
It’s totally possible that they’re doing this out of caution – it beats jaywalking or mistakenly walking before the green man lights up anyway. But there may be more to it, especially if they’re hesitating for a significant moment before crossing, or even till the green man’s already flashing.
It could mean that they’re starting to require a bit more time to process what they see. This may affect other potential situations too, from small-scale scenarios like catching a falling object, to much more fatal ones like moving away from oncoming traffic or negligent electric bike-riders.
Fall assessment #4: Hand Reaction Test
This test measures how fast their eye-to-hand coordination is. The simplest of the five tests, all that they need to do is click a mouse each time they see the red button light up.
I was needlessly kiasu during this part – there were a few times when I clicked even before the red button lit up. Gladys, on the other hand, displayed a much more measured calm throughout – something, she’d agree, that comes naturally with age.
5. THEY CAN’T STAND WITHOUT SUPPORT FOR LONGER THAN A MINUTE.
Unless it’s for free stuff or the latest food craze, nobody loves standing in line, least of all our parents. But keep a look out for when they’re queuing for their morning kopi, especially if they seem to struggle standing still for longer than a minute. Another red flag is an over-reliance on support – an umbrella or a nearby chair – when they’re standing.
These point towards a declining sense of balance which, if left unaddressed, may prevent them from being able to catch themselves from even the slightest of missteps. An over-reliance on support can potentially lead to them not be able to stand on their own as well.
Fall assessment #5: Postural Sway Test
This test assesses their overall balance. They’ll stand on a soft, slightly cushy platform with a mechanism strapped around their waist. At one end of this mechanism is a pen that will indicate on a piece of graph paper how much they sway over 30 seconds.
The graph paper momentarily brought back dreaded memories of H2 Mathematics for me but fret not – no application of math is required on your parents’ part.
When the 30 seconds were up, my body left a seemingly inscrutable line on the paper. But with some scientific magic, the physiotherapists were able to determine my level of balance – all from one squiggly line.
KEEPING UP WITH YOUR PARENTS
When it comes to our parents, sometimes the most telling signs can be the quietest ones. If your parents lead a sedentary lifestyle with little to no social activity, their chances of being a fall risk is much higher than the average senior – even more so if they’ve suffered a prior fall.
Just like how they would insist you go see the doctor whenever you fell sick as a kid, you’ll have to urge them to get themselves checked now. Consider it a role reversal of sorts – it’s now your turn to keep tabs on your parents’ health, the same way they looked after yours.
MOUNT ALVERNIA HOSPITAL REHABILITATION CENTRE
The Fall Screening And Assessment Programme is Mount Alvernia’s latest service geared towards improving seniors’ quality of life. It is preventive in nature, working to strengthen them and also to improve their general health status, function and mobility.
The physiotherapists that I worked with told me that even at 90 years old, it’s possible to regain strength and the confidence to maintain an active lifestyle. Aging is not an end-all – doing so healthily is a very possible option that can be achieved even if you’re just starting now.
You’ll go through rehab with a peace of mind at the hospital’s Rehabilitation Centre – from sports therapy to speech articulation and fluency programmes, there are several services available to address your specific needs.
There’s also a mini-gym, along with various other state-of-the-art equipment and facilities, meant to help strengthen your body to a strong enough degree and live comfortably without fear of accidents. You’ll work closely with physiotherapists who are knowledgeable and who are also incredibly congenial – going for therapy will never feel like a chore.